Keywords: Value-based programs; health; variability; quality
Value-based payment programs are payment models that reward health care providers for efficient, high-quality medical care management and surgical interventions. Nationally, federal legislation in 2008 and 2010 provided the context for the development and implementation of these models through the Centers of Medicare and Medicaid Services. In its wake, health care providers and payers caring for individuals and groups in other patient populations have adapted these payment innovations. The result has been a series of small field experiments in which local health care practices and interventions have been compared to best practices in order to discover sources of health care costs. This paper will explore two aspects of this work: (1) The techniques used by statisticians and analysts to understand the variability within and across health care providers, and (2) The ways in which statisticians and analysts have adopted quality metrics for large-scale programs to smaller populations. Both of these represent significant efforts to adopt value-based payment models that can provide better care for patients at a lower cost.